Depressed Interferon Gamma Production and Monocyte HLA-DR Expression After Severe Injury

Low monocyte HLA-DR expression as an indicator of immunodepression in very low birth weight infants

“…CARS was evident within 24 h after birth, with its nadir reached in 72 h. This behavior and associations of CARS postnatally are in accordance with adult and pediatric studies (6)(7)(8)(9)(10)(11)(12). Therefore, in adults and VLBW infants, the molecular mechanisms might also have similarities.…”

“…By contrast, infected trauma patients show a delayed return to HLA-DR >75% and a persistent low HLA-DR of 20-30% even correlates with mortality (10). In adult patients with septic shock, survivors show a recovery of HLA-DR expression on days 3-4.…”

Immunoparalysis and Adverse Outcomes from Critical Illness

“…It was those who exhibited prolonged HLA-DR down-regulation in whom secondary sepsis developed more often. These findings were confirmed by Livingston et al [18] in a separate series of adult trauma patients. It appears that the initial reduction in monocyte HLA-DR expression is indicative of the CARS state and is not itself pathologic.…”

“…If prolonged and severe, this state has been termed immunoparalysis. Characterized by markedly impaired innate immune function, immunoparalysis is now recognized as a predictor of morbidity and mortality for both children and adults [13][14][15][16][17][18]. Moreover, the phenomenon is often occult, is not heralded by any premorbid phenotype, and commonly occurs in patients previously thought to be immunocompetent.…”

Pivotal role of Interleukin-10 on microRNA-155 expression in regulation of the monocyte response in hypothermia.

“…Macrophages and dendritic cells are found in all tissues. Tissue macrophages have different names based on the tissue they were first described such as Kupffer cells for the liver or Langerhans cell for the demonstrated to be a reliable marker for outcome after trauma and burns (52)(53)(54)(55)(56)(57)(58)(59). Low expression of HLA-OR and especially the lack of up-regulation of HLA-DR after ex-vivo stimulation with LPS, correlates with increased complications and death.…”